Individual
MRS. SHIRLEY DENISE MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1452 MENLO LOOP, SPRINGFIELD, OR 97477-7678
(541) 221-4099
Mailing address
1452 MENLO LOOP, SPRINGFIELD, OR 97477-7678
(541) 221-4099
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
16030
IN
164W00000X
Licensed Practical Nurse
Primary
201130551LPN
OR
164X00000X
Licensed Vocational Nurse
VN112467
CA
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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